局灶性磨玻璃结节肺癌的CT影像表现及特征分析

Analysis of CT Imaging Manifestations and Features of Focal Ground Glass Nodule Lung Cancer

目的探讨局灶性磨玻璃结节肺癌的CT影像表现及其特征。方法收集该院2016年3月—2018年1月CT影像学检查表现为局灶性磨玻璃结节患者的临床资料。分为良性组(通过临床抗炎治疗症状好转、肺部影像学表现消失或病理证实为良性结节)和恶性组(根据肺部穿刺检查结果或手术病理资料提示恶性病灶)。对比良性组和恶性组的病理资料;良性组和恶性组的病灶大小、病变位置及形态;良性组和恶性组CT影像学特征。结果良性组中以真菌感染(38.1%)最多见(χ~2=7.483,P<0.05),恶性组中以浸润性腺癌(59.3%)最多见(χ~2=6.381,P<0.05);良性组和恶性组的病灶大小、形态分别为(22.38±6.14)mm、圆形/椭圆24例,不规则18例]、[(22.26±5.87)mm、圆形/椭圆62例,不规则56例],比较差异无统计学意义(χ~2=0.34、7.42,P>0.05);良性组和恶性组CT影像学特征对比后发现,良性组CT影像学中边缘模糊(76%)、小叶间隔增厚(33%)发生率明显高于恶性组(14%、2%),比较差异有统计学意义(χ~2=6.34、6.28,P<0.05);恶性组中分叶(83%)、毛刺(75%)、空泡征(48%)、支气管充气征(56%)、胸膜凹陷征(56%)、血管集束征(25%)的发生率明显高于良性组(10%、5%、22%、23%、10%、5%),比较差异有统计学意义(χ~2=6.24、6.98、5.11、7.54、7.11,P<0.05)。结论发现局灶性磨玻璃结节病灶时,通过分析边缘模糊、小叶间隔增厚、分叶、毛刺、支气管充气征、胸膜凹陷征、血管集束征等影像学特点,对肺部局灶性结节的良恶性鉴别可以提供诊断依据。

Objective To study from March 2016 to January 2018 the CT imaging manifestations and features of focal ground glass nodule lung cancer. Methods The clinical data of patients with focal ground glass nodule lung cancer shown by the CT imaging examination in our hospital were collected, and the patients were divided into two groups, in the benign group, the symptoms were improved by the clinical anti-inflammation, and the lung imaging manifestations disappeared, and there were benign nodules proved by the pathology, while in the malignant group, there were malignant lesions shown by the results of lung biopsy and operative pathological data, and the pathological data, lesion site, lesion site and shape, CT imaging features were compared between the two groups. ResultsThe mycotic infection 38.1% in the benign group was the most common（χ^2=7.483,P〈0.05）, and the adenocarcinoma infiltrating in the malignant group was the most common 59.3%, （χ^2=6.381,P〈0.05）, and the lesion site and shape in the benign group and in the malignant group were respectively （22.38±6.14）mm, round/oval 24 cases, irregular 18 cases and （22.26±5.87）mm, round/oval 62 cases and irregular 56 cases, and the differences were not obvious（χ^2=0.34, 7.42, P〉0.05）, and the comparison showed that the incidence rates of blurring edge and thickened lobular septa in the CT imaging in the benign group were obviously higher than those in the malignant group （76%, 33% vs 14%, 2%）, and the differences were obvious （χ^2=6.34, 6.28, P〈0.05）, and the incidence rates of lobulation （83%）, burr （75%）, vacuole （48%）, bronchial inflation （56%）, pleural indentation （56%） and vascular cluster （25%） were obviously higher than those in the benign group （ 10%, 5%, 22%, 23%, 10%, 5%） , and the differences were obvious（χ^2=6.24, 6.98, 5.11, 7.54, 7.11, P〈0.05）. Conclusion The analysis of imaging features of blurred edges, septal thickening, lobulation, burr, bronchial inflation, pleural indentation, vascular cluster when finding out the focal ground glass nodule lesion can provide diagnosis basis for the differential diagnosis of benign and malignant focal pulmonary nodules.